It's no surprise that members/patients with complex health needs account for a large share of healthcare spending. Quickly identifying and engaging them can be challenging. Predictive analytics enable care teams to accurately identify high-risk members/patients and determine the appropriate level of care and engagement needed.
Give your care and quality management teams easy-to-use predictive analytics to efficiently and effectively stratify and target high-risk members/patients to improve outcomes and lower costs.
Stratification by Projected Cost Dashboard
The QualMetrix Predictive Analytics solutions enable care and quality teams to:
- Review predictive indicators of future costs and use of services
- Leverage predictive model tools to assess likelihood of admission, re-admissions, future medical and pharmacy costs, and other issues
- Evaluate member/patient risk scores
- Find members/patients that have high care coordination risks and take action
- Gain insight into the chronic conditions of each member/patient to develop care plans and targeted campaigns
- Match predictive high-cost members/patience with efficient and cost effective providers to improve outcomes